What is Aphasia?

Aphasia is a communication disorder caused by damage to parts of the brain that control language. A person’s intellect may not be affected but they may have difficulty with:

understanding what others are saying

expressing themselves

reading

writing

doing math calculations

Aphasia is most commonly caused by a stroke but it can also be caused by head injuries, infections and brain tumors. There are three main types of aphasia:

Receptive aphasia

This is when a person has difficulty understanding what is said to them or has difficulty understanding writing, such as reading a newspaper or emails.

Expressive aphasia

This is when the person knows what they want to say but has difficulty saying words and phrases. They may also have difficulty writing down what they mean.

Anomic aphasia

This is when the person has difficulty choosing and using the right words to name people, objects, places or events.

A person may have just one of the above types of aphasia or a mixture of these. The severity of any difficulties varies depending on the amount of damage to the brain. If a person has all three types of aphasia this is called global aphasia. The person will have trouble speaking, understanding speech, reading, writing and doing math.

Some Do’s and Don’ts

There are lots of things you can do to help a person with aphasia to communicate better. The following are some ideas of things to do when you’re listening and some things to do when you’re speaking.

You as a listener

face the person and look at them

reduce any background noise, e.g. turn off the television or radio

ask the person what helps them to

listen carefully

encourage all efforts at communication whether the person is using speech, gesture or another means – respond positively

be patient, as it may take the person longer to speak and understand – give them plenty of time to speak and don’t look agitated

don’t answer for the person – let them get the message across in whatever way they can, with suggestions from you if necessary

encourage the person to use pen and paper to write things down if they can – or use props such as diaries, photo albums, pictures in magazines, and so on, to help get their message across

don’t finish off words or utterances for them

try hard to understand but don’t pretend to understand if you haven’t – be truthful and say if you don’t understand

piece the message together by asking helpful questions based on what you’ve already understood – try making suggestions and ask the person to give you other clues by gesturing, using pictures, writing, pointing to objects, and so on

ask one thing at a time

go back over and run through the message to check that you’ve understood correctly

at the end of a discussion, summarize what you think the person’s been trying to say, e.g. ‘let’s be sure I understand…’, ‘have I got that right?’

be considerate when the person is frustrated at not being able to express themselves

You as a speaker

face the person and get their full attention before you start to speak

ask the person what helps them to communicate

check that they have their glasses or hearing aid (if they usually wear these)

if the person has a hearing impairment, sit on the ‘good’ side

don’t shout

check that they understand you, e.g. ‘does that make sense?, ‘are you with me?’

speak clearly, as you would to someone else of the same age

speak in short sentences

speak slowly – but not so slowly that it distorts your natural speech rhythm, as this can be confusing and come across as patronizing

use everyday language, not unfamiliar words

talk about just one idea at a time

stress key words and be specific, e.g. ‘I went to town’ not ‘I went there’

say things in a different way if the person doesn’t understand you the first time and give extra clues through helpful gestures, facial expressions and the tone of your voice

you can also support what you’re saying by writing down key words, drawing, using pictures and photos, and so on

if you’re talking in a group, talk one at a time only – people talking all at the same time is confusing and distracting

Remember!

No two people with aphasia will present with exactly the same communication difficulties. Sometimes you may find it difficult, or impossible, to understand what the person with aphasia is trying to communicate to you. Don’t be afraid to acknowledge any difficulties. Stay relaxed and try to find out if the issue is really important or if you can come back to it later. Sometimes a break from the pressure of trying to communicate a particular idea can be helpful to the person with aphasia. It can be helpful to agree a signal that you can both use to stop and move on to another topic. Keep in mind that you shouldn’t pretend you’ve understood if you haven’t. If the issue is urgent, you can also try and get someone else to help you. Remember…be patient and honest. This demonstrates your respect for the person with aphasia.